What type of doctors repair diaphragmatic hernias?

From the Guidelines

Diaphragmatic hernias are typically repaired by thoracic surgeons, pediatric surgeons, or general surgeons with specialized training in thoracic procedures. The management of diaphragmatic hernias, as outlined in the 2023 position paper by the World Journal of Emergency Surgery 1, emphasizes the importance of prompt surgical intervention and appropriate preoperative assessment for clinical success. For congenital diaphragmatic hernias in infants, pediatric surgeons usually take the lead, as these conditions require immediate attention after birth. In adults, thoracic surgeons often handle acquired diaphragmatic hernias, which may result from trauma or develop over time.

Key Considerations

• The surgical repair involves repositioning the abdominal organs that have moved into the chest cavity and closing the defect in the diaphragm.
• This may be done through open surgery or, in less severe cases, through minimally invasive laparoscopic or thoracoscopic approaches, with laparoscopic repair being the preferred technique in hemodynamically stable patients without significant comorbidities 1.
• The specific surgical technique depends on the size and location of the hernia, with larger defects sometimes requiring mesh reinforcement, and biological and bioabsorbable meshes are recommended to reduce recurrence 1.
• Following surgery, patients typically need follow-up care with their surgeon to monitor recovery and ensure the repair remains intact.
• The complexity of diaphragmatic hernias often requires a multidisciplinary approach, particularly for congenital cases, involving neonatologists, pulmonologists, and critical care specialists in addition to the surgical team.

Surgical Specialization

• Pediatric surgeons have specialized training in the surgical treatment of children, including congenital diaphragmatic hernias, and are certified by the American Board of Surgery 1.
• General surgeons who care for pediatric surgical problems should have had a minimum 6-month rotation as a junior or senior resident during their general surgical residency on a pediatric surgical service run by a pediatric surgeon 1.

From the Research

Types of Doctors

• General surgeons 2, 3, 4, 5, 6
• Thoracic surgeons 2, 4, 6
• Abdominal surgeons 3, 4, 6

Surgical Specializations

• Thoracic surgery 2, 4, 6
• Abdominal surgery 3, 4, 6
• Laparoscopic surgery 3, 4, 6
• Emergency surgery 5

Treatment Approaches

• Open abdominal approach 2, 3, 4, 5, 6
• Thoracotomy approach 2, 4, 6
• Laparoscopic approach 3, 4, 6
• Mesh augmentation 3, 4